Dr Ewa’s Cases Flashcards

1
Q

Mx of NEC

A

Complete bowel rest, fluids and ABx

Surgery - Ladds procedure

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2
Q

Intussusception Sx

A

Prodromal coryzal symptoms causing enlarged lymph nodes
Abdo pain
Red currant jelly stool
Baby crying in episodes due to colicky pain

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3
Q

Mx of abdo pain

A

Fluids, analgesia
Rectal air enema / contrast enema
Surgery detangling or resection of bowel

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4
Q

Causes of abdo pain in kids

A
NEC
Pyloric stenosis 
Constipation 
Appendicitis 
Intussusception 
DKA 
HSP 
Mesenteric addenitis
Gastroenteritis 
Coeliac
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5
Q

Abdo pain after eating in slim teenager ? Mx?

A

H Pylori - stool sample

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6
Q

What is seen on CXR of duodenal atresia?

A

Double bubble sign

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7
Q

Sx of pyloric stenosis ?

A

Projectile Vomiting & crying

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8
Q

Sx of cows milk protein allergy mild and severe

A

Mild to mod - colick, diarrhoea, food aversion, constipation, blood in stool, erythema
Severe - failure to thrive, atopic dermatitis

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9
Q

What type of reaction is anaphylaxis

A

IgE mediated

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10
Q

Mx of cows milk protein allergy

A

Avoid all milk products - inc cheese yoghurt etc (mother and baby if breastfeeding)
Tell mother to take vitamin D while breastfeeding
Try above for 6 weeks then rechallenge
Try hydrolysed formula is formula fed baby

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11
Q

Causes of breathing difficulty

A

Asthma
Croup
Bronchiolitis
Anaphylaxis

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12
Q

Description of asthma Sx

A

Interval symptoms

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13
Q

Signs of difficulty breathing

A
Can’t speak full sentences
RR high 
Intercostal and sub coastal recessions 
Nasal flaring 
Tracheal tug 
Head bobbing 
Shunting
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14
Q

What is a bad sign in asthma?

A

Rising and normalising PCO2
Can’t speak full sentences
Peak flow < 33%

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15
Q

PC of bronchiolitis

A

Fever, cough, breathing difficulties, inspiratory creps (crunchy noise) plus wheeze. High RR

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16
Q

What causes bronchiolitis

A

RSV

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17
Q

Mx of bronchiolitis

A

Supportive - o2 and NG feeding if needed

CPAP if needed

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18
Q

What can be given to prevent bronchiolitis in at risk babies? Eg prem

A

Panulizimab AB given every month

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19
Q

Features of croup

A

Coryzal Sx
Barking cough
Stridor

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20
Q

What causes croup

A

Parainfluenza

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21
Q

Mx of croup

A

All get dexamethasone

Can give nebulised adrenaline if needed but they can get worse v quickly after

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22
Q

What score is used to categorise croup?

A

Westley score

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23
Q

Features of epiglottitis

A
Stridor 
Drooling 
Leaning at end of bed 
High fever 
Look toxic
24
Q

Cause of epiglottis

A

HiB

25
Q

Mx of epiglottitis

A

ABx IV
Senior anaesthetist help
Intubation if needed

26
Q

Sx of pneumonia

A
Fever 
Productive cough 
Chest pain 
Coryzal symptoms 
Tachypnoea and tachycardia
27
Q

Mx of pneumonia

A

CAP - amoxicillin, antipyretics

Complicated - IV ABx, plus fluids

28
Q

What causes whooping cough

A

Bordatella pertussus

29
Q

Mx of whooping cough and why

A

Erythromycin - makes them less infectious to others

30
Q

Complication of whooping cough

A

Apnoea

31
Q

Sx of meckels

A

Blood in stool

Pain in abdo

32
Q

Sx of periorbital cellulitis

A

Swollen eyes
Sometimes can’t open eye
Reduced eye movements and vision

33
Q

Mx of periorbital cellulitis

A

ABx
Nasal wash and sprays
Decongestants
MRI to check it’s not spread backwards

34
Q

What is orbital cellulitis ?

A

ENT emergency

35
Q

Sx of otitis media

A

Pain
Fever
Bulging red ear drum

36
Q

Mx of otitis media

A

Usually nothing as it was resolve

ABx

37
Q

When does foreign body in ear need to be removed immediately?

A

If it’s organic, as it will swell

38
Q

Features that make febrile seizure into complex

A

More than 15 mins
May be repetitive
May have Todd’s paresis - paralysis of one side in seizure
Fever over 38

39
Q

Does simple febrile convulsions risk you for epilepsy?

A

No - complex do

40
Q

What is petite mal seizure?

A

Absence seizures - kid will zone out then come back

41
Q

What are infantile spasms?

A

Repetitive movements in between crying

Common in children with HIE

42
Q

EEG sign of infantile spasms

A

Hipps arrhythmia

43
Q

Complications of infantile spasms

A

Regression of skills and development

44
Q

Mx of infantile spasms

A

IV steroids and vigabatrin

45
Q

What is adrenarchy?

A

Starting puberty early

46
Q

When is delayed puberty?

A

13 in girls, 13.5 in boys

47
Q

Causes of delayed puberty

A
Poor nutrition 
Turners 
Inflammatory disorders - UC/coeliac
Pituitary issues 
Radiation
48
Q

Normal growth velocity in pre pubertal child

A

5cm a year

49
Q

How do you calculate growth velocity

A

Measure in 6 month periods

50
Q

How is jaundice Ix and Mx in neonates?

A

Check SBR
Phototherapy
If bad, exchange transfusion

51
Q

Big cause of prolonged jaundice in neonates

A

Breast milk jaundice

52
Q

Important cause of jaundice in neonates to pick up

A

ABO mismatch - haemolysis of RBCs

53
Q

Causes of unconjugated high BR

A

General infection eg UTI

Sickle cell / G6PD infection

54
Q

What happens if you get BR in basal ganglia?

A

Conictrus - permanent damage causing CP

55
Q

Causes of conjugated high BR

A

Biliary / liver problems - eg atresia

56
Q

Causes of leg pain

A
Transient synovitis 
Septic arthritis 
SUFE 
Congenital hip Dyslocation
Rickets 
Trauma 
Juvenille idiopathic arthritis 
Sickle cell